Table 3.
Multivariable association between categorical eGFR updated slope measure and cardiovascular disease outcomes in 30,222 adults with type 2 diabetes mellitus and CKDa
| Model covariates | Heart failure (n = 1185) | Myocardial infarction (n = 311) | Ischemic stroke (n = 195) | MACE plus (n = 1588) |
|---|---|---|---|---|
| Age at baseline, yr | 1.05 (1.04–1.05) | 1.02 (1.01–1.04) | 1.05 (1.04–1.07) | 1.04 (1.04–1.05) |
| Male gender | 1.34 (1.18–1.51) | 1.85 (1.46–2.35) | 1.19 (0.88–1.60) | 1.41 (1.27–1.56) |
| CKD updated slope categories¤ | ||||
| Updated eGFR slope ≥3 | Reference group | Reference group | Reference group | Reference group |
| Updated eGFR slope 0–3 | 1.02 (0.85–1.23) | 1.10 (0.78–1.57) | 1.19 (0.76–1.85) | 1.06 (0.90–1.24) |
| Updated eGFR slope –3 to <0 | 1.23 (1.03–1.47) | 1.16 (0.83–1.63) | 1.32 (0.86–2.01) | 1.22 (1.05–1.42) |
| Updated eGFR slope eGFR < –3 | 1.50 (1.27–1.76) | 1.39 (1.01–1.91) | 1.33 (0.88–2.01) | 1.45 (1.26–1.67) |
| Never-smoker | Reference group | Reference group | Reference group | Reference group |
| Ex-smoker | 1.14 (1.01–1.30) | 1.03 (0.80–1.31) | 0.89 (0.65–1.22) | 1.09 (0.98–1.21) |
| Current smoker | 1.35 (1.11–1.64) | 1.28 (0.89–1.83) | 1.43 (0.91–2.23) | 1.33 (1.13–1.57) |
| Systolic blood pressure, mm Hg | 1.01 (1.00–1.01) | 1.02 (1.01–1.03) | 1.00 (0.99–1.01) | 1.01 (1.00–1.01) |
| Diastolic blood pressure, mm Hg | 0.98 (0.97–0.99) | 0.98 (0.96–1.00) | 1.01 (0.98–1.03) | 0.99 (0.98–0.99) |
| Body mass index ≥25 kg/m2 | 1.23 (1.04–1.45) | 0.81 (0.61–1.08) | 1.10 (0.75–1.62) | 1.13 (0.98–1.30) |
| Low-density lipoprotein, mmol/lb | 1.00 (1.00–1.00) | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (1.00–1.00) |
| Triglycerides, mmol/lc | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) |
| Hyperkalemia >5.5 mmol/l | 1.32 (0.97–1.81) | 1.29 (0.71–2.37) | 1.29 (0.57–2.92) | 1.32 (1.01–1.74) |
| Renin–angiotensin–aldosterone system inhibitors medication | 1.29 (1.08–1.53) | 0.94 (0.69–1.28) | 0.93 (0.64–1.35) | 1.17 (1.01–1.35) |
| Mineralocorticoid receptor antagonist treatment | 2.96 (2.44–3.59) | 1.29 (0.75–2.21) | 1.00 (0.47–2.14) | 2.50 (2.09–2.99) |
| Diabetes duration ≥5 yr | 1.36 (1.21–1.53) | 1.34 (1.07–1.68) | 1.26 (0.94–1.67) | 1.35 (1.22–1.49) |
CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate.
Bold text indicates statistically significant results.
Data are shown as hazard ratio (95% confidence interval). Estimated glomerular filtration rate slopes are based on the Chronic Kidney Disease Epi Equation by Levey et al.23 British National Formulary coding was used for mineralocorticoid receptor antagonist and renin–angiotensin–aldosterone system inhibitor medication angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Exclusions were all prevalent cardiovascular disease events before follow-up.
Missing for low-density lipoprotein n = 7438 (24.6%);
Missing for triglycerides n = 4668 (15.5%). ¤